Objective: To observe the clinical effects of moxibustion at abdominal acupoints for slow transit constipation (STC) due to yang deficiency of the spleen and kidney. Methods: A total of 52 cases with slow transit constipation in conformity with the inclusion criteria were selected and divided into a control group and an observation group according to their visit order and random digital table, 26 cases in each group. Patients in the control group received routine nursing guide. Besides the same routine nursing guide, patients in the observation group received moxibustion at the abdominal acupoints, once every day. The course of the treatment was 4 weeks in the two groups, and the 3-month follow-up was given after the course was finished, for comparing the clinical symptoms, results of colon transit tests, scores of depression/anxiety scale and nursing satisfaction. Results: The total effective rate was 92.3% in the observation group and 69.2% in the control group, with a significant difference between the two groups. After the treatment and during the follow-up checks, the scores of Chinese medical symptoms in the two groups were remarkably decreased than those before the treatment (all P<0.01); the scores of the observation group were obviously lower than those in the control group (all P<0.01). The discharge rates of the markers in the two groups were remarkably increased than those at the same time period before the treatment; moreover, the discharge rates of the markers at various time periods were remarkably better in the observation group than those in the control group (P<0.01). SDS and SAS scores were remarkably decreased after the treatment in the two groups (P<0.01). In comparison of SDS score between the two groups after the treatment, the difference was statistically significant (P<0.01). In comparison of SAS score between the two groups after the treatment, the difference was statistically significant (P<0.05). The nursing satisfaction was 96.2% in the observation group after the treatment, obviously better than that in the control group (73.1%). The recurrence rate was 8.3% in the observation group, remarkably lower than that in the control group (33.3%). Conclusion: Moxibustion at the abdominal acupoints plus routine nursing can remarkably improve the colon transit functions and anxious and depressive emotion in patients with STC, and the therapeutic effects are remarkable. Not only the clinical satisfaction is higher, but the recurrence rate is obviously lower than that of routine nursing.

Objective: To investigate the effect of taurine on learning and memory impairment, cytokines secretion in rats intrahippocampally injected with ?-amyloid (A?) 1-40. Methods: SD rats were randomly divided into control group, A? injected group, taurine (0.3g/kg?d, 0.6g/kg?d) groups. The rats were fed with taurine for 7 days, and then subjected to bilateral intrahippocampus injection of A?1-40 or vehicle. Two weeks later, all rats performed Morris water maze test. The contents of IL-6, TNF-? were checked by way of radio-immunity assay for hippocampus samples. Results: Compared with A?model group, the escape latency and distance were significantly reduced in taurine (0.6g/kg?d) group; the ratio of swimming distance in the target quadrant to that in the whole pool of the probe trial; the content of cytokines of IL-6 and TNF-?in hippocampus were reduced significantly. Conclusion: Taurine can effectively attenuate the cognitive dysfunction caused by A?1-40 in rats. The reduced cytokines content in hippocampus might contribute to this effect.

Objective To determine the agreement of interobserver and intraobserver in diagnosing early glaucoma by optic disc morphology,and to explore the efficacy of established methods for evaluating glaucomatous optic discs.Design Prospective study. Participants Clinicians and evaluating methods for glaucomatous optic discs.Methods 120 digital fundus photographs were enrolled including early glaucoma eyes(67 cases)and non-glaucoma eyes but with glaucomatous appearance(53 cases),which were collected in Tongren Hospital.Thirteen ophthalmologists as observers were divided into three groups:GroupⅠ(5 clinicians)were trained with stan- dardized methods for evaluating glaucomatous optic disc damage recently.GroupⅡ(4 clinicians)were ophthalmologists majoring in glaucoma.GroupⅢwere ophthalmologists not specializing in glaucoma.In general groupⅡandⅢ,none had been trained with the es- tablished criteria.Observers evaluated the photos 3 times,with an interval time of 3 days.Kappa statistics were used to evaluate agree- ment between the intraobserver and interobserver.Main Outcome Measures Interobserver and intraobserver agreement,kappa value. Results In GroupⅠ,4 clinicians were in almost perfect agreement,1 clinician was in substantial agreement,kappa value ranging from 0.779(90.0%)to 0.966(98.3%).In GroupⅡ,almost perfect agreement occurred in 2 clinicians,substantial in 1 clinician and moderate in 1 clinician,kappa value ranging from 0.506(82.5%)to 0.866(93.3%).In GroupⅢ,the agreements in 4 clinicians were substantial, moderate,fair,and slight,respectively,kappa value ranging from 0.094(54.2%)to 0.778(89.2%).In term of interobserver agreement for glaucoma diagnosis,kappa values in GroupⅠranged from 0.768 to 0.983,in GroupⅡ0.354-0.834,in GroupⅢ0.335-0.737,respec- tively.Conclusions Intraobserver and interobserver agreement rates in early glaucoma diagnosis are substantially improved through training on optic disc morphologic evaluation methods.Establishing the diagnosis criteria for glaucomatous optic disc damage can raise the correct rate of diagnosis.

In this study, we developed a novel liposome-silica hybrid nano-carrier for tumor combination therapy via oral route, using paclitaxel and cyclosporine as a model drug pair. Optimization of the preparation of the drug-loading formulation and characterization of its physicochemical parameters and drug release profile were performed in vitro. Then in vivo pharmacodynamics and pharmacokinetics studies were performed. The results showed that the obtained formulation has a small particle size (mean diameter of 100.2 +/- 15.2 nm), a homogeneous distribution [the polydispersity index was (0.251 +/- 0.018)] and high encapsulation efficiency (90.15 +/- 2.47) % and (80.64 +/- 3.52) % for paclitaxel and cyclosporine respectively with a mild and easy preparation process. A sequential drug release trend of cyclosporine prior to palictaxel was observed. The liposome-silica hybrid nano-carrier showed good biocompatibility in vivo and co-delivery of cyclosporine and paclitaxel significantly enhanced the oral absorption of paclitaxel with improved anti-tumor efficacy, suggesting a promising approach for multi-drug therapy against tumor and other serious diseases via oral route.
ATP-Binding Cassette, Sub-Family B, Member 1 ; antagonists & inhibitors ; Administration, Oral ; Animals ; Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacokinetics ; pharmacology ; Biological Availability ; Cyclosporine ; administration & dosage ; pharmacokinetics ; pharmacology ; Drug Carriers ; chemistry ; Female ; Liposomes ; chemistry ; Male ; Mice ; Nanoparticles ; Neoplasm Transplantation ; Paclitaxel ; administration & dosage ; pharmacokinetics ; pharmacology ; Particle Size ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sarcoma 180 ; pathology ; Silicon Dioxide ; chemistry ; Tumor Burden ; drug effects

BACKGROUND: Edaravone can alleviate brain injury and improve neurological functions and symptoms. This study aimed to investigate the effect of edaravone on the p38Mitogen-activated protein kinases/Caspase-3 (p38MAPK /Caspase-3) pathway after diffuse brain injury (DBI) in rats. METHODS: DBI models were established according to the description of Marmarou's method. A total of 250 rats were divided (random number) into four groups: control group (CG, n=45), model group (MG, n=77), low-dose edaravone group (n=67, dosage 5 mg/kg) and high-dose edaravone group (n=61, dosage 10 mg/kg). After 1, 6, 24, 48, and 72 hours after injury, brain tissues were collected. The changes of neuron morphous in the hippocampal region were observed through Nissl staining. The expression levels of phosphorylated p38MAPK and caspase-3 were detected by immunohistochemistry and Western blotting respectively. Learning and memory function were tested with Morris water maze from the 3rd to 7th day after injury. RESULTS: Some neurons had histopathologic changes of necrosis and apoptosis in the model group compared with the control group. The phosphorylated p38MAPK expressions increased at 1, 6, 4, and 48 hours (P<0.05), but no significant difference was observed at 72 hours (0.54±0.19 vs. 0.40±0.14, P>0.05). Caspase-3 expressions increased at 6, 24, 48, and 72 hours respectively (P<0.05), but there was no significant difference at 1 hour (0.59±0.29 vs. 0.40±0.17, P>0.05). From the 3rd to 6th day during the Morris water maze test, the latency to find the platform was significantly prolonged (P<0.05) and times of rats crossing the platform was decreased on the 7th day (2.28±1.18 vs. 8.20±1.52, P<0.05). The phosphorylated p38MAPK expressions decreased at 6, 24 and 48 hours respectively in the low dose edaravone group compared with the model group (P<0.05), whereas no significant difference was seen at 1 hour (1.66±0.80 vs. 1.85±0.86, P>0.05). Caspase-3 expression decreased at 6, 24, 48, and 72 hours (P<0.05). The latency to find the platform was significantly shortened (P<0.05), and times of rats crossing the platform increased (4.17±1.15 vs. 2.28±1.18, P<0.05). The above mentioned parameters changed more significantly in the high-dose edaravone group than in the low-dose edaravone group. CONCLUSION: Edaravone can alleviate brain tissue damage after DBI, inhibit p38MAP signal activation after early injury, reduce the expression of caspase-3, and promote the recovery of neurological function in the late period.

Objective To study on the metal clip installation to avoid post-operative bleeding in pa- tients accepted papilla sphinctecotomy.Methods One hundred and eighty five patients who accepted ERCP +EST were divided into two groups:Group 1 was given routine regimen alone(N=95),group 2,given routine regimen and metal clip to prevent post-operative bleeding.Results The postoperative bleeding hap- pened in 3(3.2%)cases of Group 1 and none in Group 2,there is significant difference between these two groups(P＜0.05).The breeding cases in group 1 were controlled by metal clip under endoscopy successful- ly.Conclusion Preventive usage of metal clip was significantly decreased the incidence of post-operative bleeding in EST patients.

Objective To characterize the antibiotic resistance,homology and carbapenemase genotypes of imipenem resistant Acinetobac1ter baumannii isolated from our hospital,and analyze the clonal relatedness of the test strains.Methods Ninety five strains of imipenem resistant A.baumannii were isolated from August 2003 to December 2004 in the First Affiliated Hospital, College of Medicine,Zhejiang University.The MICs of 16 antimicrobial agents against these strains were determined by agar dilution and E-test method.The homology of these isolates was analyzed by pulse-field gel electrophoresis(PFGE).The coding gene of carbapenemases was amplified.PCR products were purified,cloned and sequenced.Plasmid DNA was extracted and purified.Conjugation and Southern blot were performed to locate the position of oxa 23 gene.Results The resistance rates to ampicillin-sulbactam and cefoperazone sulhactam were 67.9% and 30.2%.Polymyxin E had the lowest resistance rate of 17%. The resistance rate to other antimicrobial agents was higher than 90%.The 95 strains,isolated from 10 clinical units,were classified into 6 clones.Clones A and B were predominant clones.All strains produced carbapenemases which were confirmed as OXA 23 by PCR and sequencing analysis.No plasmid was extracted and conjugation was not successful.Southern bolt showed that oxa-23 gene was located on Apal-digested chromosomal segments about 220 kb and 200 kb in Clones A and B,re spectively.Conclusions OXA 23-producing A.baumannii has become one of the most important multi-resistant pathogens in our hospital.Clones A and B have widely spread in our hospital.Oxa-23 gene is located on chromosomal DNA.

Objective To investigate the resistant mechanism of imipenem-resistant K. pneumoniae.Methods The minimal inhibitive concentrations (MICs) of the antimicrobial agents were determined by Etest.Isoelectric focusing electrophoresis (IEF),plasmid extraction,conjugation, transformation,PCR amplification,cloning and sequencing were carried out for analyzing the encoding gene of ?-1actamases.Results Three kinds of ?-1actamases were detected with pIs of 7.2,6.7,and 5.4.in a clinical strain of K.pneumoniae.These ?-1actamases were TEM-I (pI,5.4),SHV-12 (pI,8.2) and KPC-2 ( pI,6.7 ) confirmed by sequencing of the PCR products.Only one band of ?-1actamase with pI 6.7 was displayed in the transformant.A 1500 bp segment,which contained the KPC-2 gene confirmed by nucleotide sequence analysis,was cloned from a 60 000 bp plasmid of the transformant.Conclusion The strain of K.pneumoniae resistant to imipenem produces a plasmid-mediated carbapenemase KPC-2 which belongs to Bush group 2f,class A ?-1actamase.

Objective: To observe the tolerability of Chinese melanoma patients to four-week high-dose interferon alfa-2b(INTRON A(R)，Schering-Plough)therapy. Methods:A total of 29 patients with high risk melanoma[American Joint Committee on Cancer Staging(AJCC)ⅡB-ⅢC]who received adjuvant interferon therapy in our hospital between September 2007 and May 2009 were retrospectively reviewed.Patients received 4 hours of intravenous infusion of interferon alfa-2b fdose range，22.00 million international unit(MIU)to 33.75 MIU]Ⅳ 5 days/week for 4 weeks.The adverse events were evaluated with National Cancer Institute Common Toxicity Criteria(NCI 2.0 version). Results: The average daily dose was 17.63 MIU/(m~2·d).The therapy was ended in two patients because of poor wound healing or intolerability to severe fatigue.The most common adverse events were myelosuppression.Grade 3/4 neutropenia was observed in 69% (20/29)patients and was rapidly reversed after conventional support interventions.Grade 1/2 abnormal hepatic function occurred in 18 cases(62%).Twenty-six patients were followed up for 3 to 22 months.Five patients developed early progression:one with local recurrence，two with regional lymph node metastasis one with in-transit metastasis in the affected limb,and one with distant metastasis. Conclusion: High-dose interferon alfa-2b regimen can be well tolerated by Chinese patients but cannot effectively inhibit subclinical lesions.

OBJECTIVETo assess the clinical efficacy of the therapeutic schema for treatment of diabetic peripheral neuropathy (DPN) with ligustrazine and citicoline injection in combination.

METHODSAdopting double-centered randomized controlled trial, 300 patients were randomly assigned to 3 groups, who were treated respectively by ligustrazine plus citicoline (group A), ligustrazine alone (group B) and citicoline alone (group C). Clinical efficacy, symptomatic integral (SI), electromyogram ( EMG), blood sugar and blood lipids were assessed 4 weeks after treatment, and the clinical efficacy and SI were assessed at the end of 3-month follow-up.

RESULTSAfter 4-week treatment, improvements of blood sugar and blood lipids were seen in all the three groups, showing insignificant difference among them (P > 0.05). But the clinical efficacy, improvement of SI and EMG in group A were superior to those in group B and C (P < 0.05), while the difference between group B and C was insignificant. No severe adverse reaction was found. Results at the end of 3-month follow-up showed that the clinical efficacy in group A was still better than in the other two groups, so did the SI (6.39 +/- 2.04 vs 8.36 +/- 1.17 and 8.05 +/- 1.34, P < 0.05).

CONCLUSIONThe therapeutic schema of using ligustrazine and citicoline in combination is effective and safe for improving DPN, and worthy of clinical spreading.

Adolescent ; Adult ; Aged ; Cytidine Diphosphate Choline ; therapeutic use ; Diabetic Neuropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Young Adult